Thought leadership on the use of innovation to solve health care access, quality, and funding issues.
From the category archives:
Averde Health continues their rapid expansion across Florida with the addition of University of Florida Physicians and Shands HealthCare in Jacksonville and Gainesville to its provider network.
UF Physicians includes more than 80 physician practices located throughout north central and northeast Florida staffed by UF faculty physicians. The Shands HealthCare system is comprised of two academic [...]
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BlueCross BlueShield of South Carolina and the Palmetto Health Family Medicine Center/University of South Carolina School of Medicine Department of Family and Preventive Medicine will begin a project on July 1 that features a new payment model to reward improved health outcomes and coordinated care within the complexities of our health care system.
The payment arrangement [...]
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In tandem with athenahealth, Humana offers solutions such as real-time adjudication, which enables health-plan members to have a claim processed instantly before leaving the doctor’s office.
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Health Alliance Medical Plans, a provider-sponsored health insurer in the Midwest, has licensed Thomson Reuters Treatment Cost Calculator, an application that tells health plan members how much they will pay out-of-pocket for upcoming healthcare services.
The Treatment Cost Calculator generates cost estimates based on a health plan’s claims data at the provider level, so the estimates [...]
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Increasingly common insurance plans that encourage patients to receive care from physicians who keep medical costs lower are based on unreliable estimates of doctor performance and may not achieve the intended savings, according to a new RAND Corporation study.
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Unlike an EHR or EMR, which captures a patient’s medical record at just one hospital or medical practice, TriZetto’s PHR captures the patient’s record of care from all the providers that file claims.
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The initiative, which will simplify information flow between health plans and doctors’ offices, and between health plans and hospitals, is comparable to what ATMs did for banks and consumers.
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The primary conclusion reached from the research is that healthcare pricing transparency is not possible under the current practices and pricing policies of most hospitals and some ASCs.
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“Offering pricing and quality data transparency represents a huge step forward in empowering healthcare consumers with information so they can make informed decisions regarding their medical care,” said Myra Ameigh, President of Vistar Technologies.
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“TriZetto’s highly integrated information systems permit access to a considerable amount of additional data, enabling us to further enhance population management, conduct predictive modeling and help members by anticipating health issues,” said Barbara Downs, senior vice president and chief operating officer, CDPHP.
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